Traumatic pneumothorax: is a chest drain always necessary?

OBJECTIVE

To examine the management of traumatic pneumothorax in a department where some of these injuries do not receive chest drains.

METHODS

A retrospective study of the management of traumatic pneumothorax was performed on a unit where historically many of these injuries have been treated conservatively.

RESULTS

54 pneumothoraces in a three year period were identified. Of these, 29 injuries (54.7%) were initially managed without drainage. Two patients subsequently had chest drains inserted as a result of asymptomatic radiological enlargement of the pneumothorax while inpatients. No patients deteriorated clinically during conservative treatment.

CONCLUSIONS

Chest drain insertion for small or moderate sized traumatic pneumothoraces, in the absence of other significant injuries or the need for intermittent positive pressure ventilation (IPPV), may be unnecessary.